Paroxysmal Nocturnal Hemoglobinuria (PNH)
Conditions
Keywords
siRNA, PNH
Brief summary
The first-in-human Phase 1/Phase 2a study described herein will evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of ADX-038 in both healthy participants (HP) and in patients with paroxysmal nocturnal hemoglobinuria (PNH).
Detailed description
The clinical study described in this protocol is a Phase 1/Phase 2a study evaluating safety, tolerability, PK, and PD of ADX-038. The study consists of 2 parts: 1. Phase 1 - Randomized, double-blind, placebo-controlled, parallel group, single ascending dose (SAD) in HP with up to 5 dose cohorts. 2. Phase 2a - Open label, single-arm (ADX-038), 2 dose study in participants with paroxysmal nocturnal hemoglobinuria (PNH) and residual anemia on a standard-of-care (SOC) anti-C5 regimen of ravulizumab or eculizumab.
Interventions
siRNA duplex oligonucleotide
Saline
Sponsors
Study design
Masking description
Masking is only applicable to Phase 1 in HP. Phase 2a is open label and there is no masking.
Intervention model description
Model Description
Eligibility
Inclusion criteria
Phase 1 Key Inclusion Criteria * 18 to 55 years of age * Participants who are healthy as determined by medical evaluation * History of recent meningococcal, pneumococcal and Haemophilus influenzae type B vaccinations or willing to be vaccinated * Screening tests negative for illicit drug, nicotine, and alcohol use Phase 1 Key
Exclusion criteria
* History of any significant medical conditions, except for completely excised non-melanoma skin cancer or low grade cervical intraepithelial neoplasia without evidence of recurrence within the prior 3 months * Any viral, bacterial, parasitic, or fungal infection within the prior 30 days * Frequent respiratory, nasopharyngeal or ear infections (more than 5 infections per year) * History of environmental exposure or sick contact that increase the risk of meningococcal, pneumococcal and/or Haemophilus influenza type B infections * Complement deficiency or immunodeficiency syndrome * Major surgery or significant traumatic injury within the prior 3 months * History of anaphylaxis or hypersensitivity reactions * History of penicillin allergy * History of splenectomy * History of alcohol abuse or illicit drug use * Donated plasma within the prior 7 days * Donated blood or loss more than 400 milliliters of blood (excluding blood volume drawn at screening) within the prior 90 days * Screening estimated creatinine clearance of less than 60 milliliters per minute * Screening hematology, serum chemistry, or coagulation parameters that are outside the normal range * Screening vital signs that are abnormal per protocol specification * Screening electrocardiogram findings that are clinically significant * Pregnant or lactating females * Use of prescription (except for contraceptives and study-related prophylactic antibiotics) or over-the counter medications (except for paracetamol or ibuprofen) or vitamins/supplements within the prior 7 days * Use of medications that may reduce the effectiveness of hormonal contraceptives within the prior 28 days * Use of an investigational therapeutics within the prior 30 days or within the expected washout (at least 5 half-lives) * Unwilling or unable to adhere to study-related prophylactic antibiotics requirements Phase 2a Key Inclusion Criteria * at least 18 years of age * Diagnosis of paroxysmal nocturnal hemoglobinuria based on documented clone size * Hemoglobin concentration of less than 12 gram per deciliter * History of recent meningococcal, pneumococcal and Haemophilus influenzae type b vaccinations or willing to be vaccinated * On a stable anti-C5 regimen for greater than or equal to 12 weeks prior to Day 1 Phase 2a Key
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Safety in Healthy Volunteers | 365 days | To evaluate the safety and tolerability of ADX-038 in HVs by incidence, relationship, and severity of adverse events and serious adverse events |
| Safety in Paroxysmal Nocturnal Hemoglobinuria Participants | 365 days | Evaluate the safety and tolerability of ADX-038 by incidence, relationship, and treatment-emergent adverse events and serious adverse events. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pharmacokinetics in Healthy Participants | 8 days | To characterize the Pharmacokinetics of ADX-038 in HPs by measuring the Maximum observed plasma concentration (Cmax) |
| Pharmacodynamics in Healthy Participants | 365 days | Change from base in plasma concentrations over time in Complement factor B (CFB) protein via assay measurement |
| Pharmacodynamics in Paraxysmal Nocturnal Hemoglobinuria | 365 days | Evaluate the changes in hemoglobin concentrations |
Countries
Australia, United Kingdom